| Objective1.To explore and discuss the effect of the Eight steps of shoulder movement and the Enneagram therapy on the affected limb function of breast cancer patients after surgery.2.To explore and discuss the effect of two intervention methods on the psychological status of breast cancer patients after surgery.MethodsBy convenience sampling,selected 102 patients who met the inclusion criteri-a for 10 days after breast surgery in a Tertiary hospital in Qingdao from April 2019 to December 2019.Patients were numbered in the sequence of outpatientre gistration,and were randomly assigned according to "excel",finaly 52 patients in the control group and 50 patients in the observation group.The two groups of patients were based on basic nursing,treatment and health education.The patients in the two groups before grouping were given routine rehabilitation exercises and routine psychological care.On the 10th day after surgery,at the end of the grouping the patients in the control group continued the follow-up routine rehabilitation exercise and routine psychological nursing,the intervention of patients in the observation group was changed to the Eight steps of shoulder movement and the Enneagram therapy.The Eight steps of shoulder movement mainly include Commencing Form,Panzuxiashi,Boyunjianri,Hemingxionghuang,Lubenhuxiao,Closing Form,there are 8 main moves,practice 3 days a week,on every Mondays,Wednesdays,and Fridays,exercises are performed once each morning and evening for 30 minutes each;the Enneagram therapy includes 6 topics:"awakening","fundamental","regression","transformation","deep transformation","breakthrough",divided into 6 times,group therapy is performed once every 2 weeks,including a total of 6 times,1 hour each time.At the end of the grouping,the researchers themselves taught two groups of patients about exercise interventions.The time,frequency,and duration of the patient’s own practice were the same until the end of 12 weeks of intervention.Through video conference guidance,in-hospital face-to-face guidance,follow-up,WeChat reminder to urge patients to practice;control the quality of patients’exercises through collective video exercises,Keep APP exercise reports and exercise videos;and use the reward mechanism to ensure compliance.A total of 3 evaluations were performed in this study.The Constant-Murley scale,functional exercise compliance scale,and HADS scale were used to evaluate the two groups of patients before the intervention,4 weeks,and 12 weeks after intervention.Scale assessment was completed in the outpatient clinic before the intervention,and patients were re-assessed to the scale at the time of 4 weeks of intervention and 12 weeks of intervention when patients were admission for intervention or during chemotherapy.Those who delay admission due to other reasons may make up the time with the investigator within 3 days.Statistical analysis was performed using SPSS 23.0 and WPS.Results1.Comparison of functional recovery of affected limb function between two groups of breast cancer patients after surgeryThe Eight steps of shoulder movement and the Enneagram therapy were used for 4 weeks and 12 weeks,the total scores of functional recovery of the affected limb in the observation group were(64.06±5.64)、(88.04±3.56),the total scores of functional recovery of the affected limb in the control group were(59.12±5.39)、(72.54±4.93).The results of variance analysis of repeated measurements showed that:the overall recovery of postoperative limb function in the two groups of breast cancer patients was statistically in the time effect,between-group effect and interaction effect(P<0.05).Single factor analysis of variance repeated measurement showed that:the scores of pain,ADL,ROM,and muscle strength of the affected limb at different time points in the two groups were statistically significant(P<0.05).Independent sample T-test results showed that:at the same time point,the patients in the observation group had higher recovery of all dimensions of the affected limb and the total recovery of the affected limb function than those in the control group,with statistically significant differences(P<0.05).2.Comparison of functional exercise compliance between two groups of breast cancer patients after surgeryThe Eight steps of shoulder movement and the Enneagram therapy were used for 4 weeks and 12 weeks,the total postoperative functional compliance scores of patients in the observation group were(54.90±3.56)、(53.22±2.53),postoperative functional compliance scores of patients in the control group were(51.71 ±4.57)、(48.67±0.68).The results of variance analysis of repeated measurements showed that:the overall compliance of postoperative limb functional exercise in breast cancer patients in the two groups was statistically significant in the time effect,between-group effect and interaction effect(P<0.05).Single factor analysis of variance repeated measurement showed that:the total score of functional exercise compliance and the recovery of each dimension in the two groups at different time points were compared respectively,and the difference was statistically significant(P<0.05).Independent sample T-test results showed that:after 4 weeks of intervention,the scores of patients’ compliance with physical exercise and active advice seeking in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).After 12 weeks of intervention,the scores of physical exercise compliance,matters needing attention compliance and active advice compliance in the observation group were all higher than those in the control group,with statistically significant differences(P<0.05).3.Comparison of anxiety and depression after surgery between two groups of breast cancer patientsThe Eight steps of shoulder movement and the Enneagram therapy were used for 4 weeks and 12 weeks,the total score of HADS-A in the observation group of patients were(8.40±2.04)、(10.26±3.17),the total score of HADS-A in the control group were(10.15±3.22)、(12.98±4.90);the total score of HADS-D in the observation group of patients were(8.42±2.91)、(9.92±3.04),the total score of HADS-D in the control group were(10.25±3.69)、(12.37±4.59).The results of variance analysis of repeated measurements showed that:the postoperative anxiety status of the two groups of breast cancer patients was compared,and the time effect,between-group effect and interaction effect were statistically significant(P<0.05).The comparison of postoperative depression in breast cancer patients between the two groups was statistically significant at time effects and between-group effect(P<0.05).Independent sample T-test results showed that:after 4 weeks of intervention,the scores of HADS-A and HADS-D in patients of type 2 and type 6 and HADS-A in patients of type 9 in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After 12 weeks of intervention,the scores of HADS-A and HADS-D in patients of type 2,6 and 9 in the observation group were all lower than those in the control group,with statistically significant differences(P<0.05).Conclusion1.The Eight steps of shoulder movement and the Enneagram therapy can improve the motion of shoulder joint on the affected side of breast cancer patients after surgery,increase the muscle strength of the affected limb,improve the self-care ability of the affected limb,reduce the postoperative pain of breast cancer patients,promote the compliance of postoperative functional exercise of breast cancer patients.2.The Eight steps of shoulder movement and the Enneagram therapy can relieve postoperative anxiety and depression of breast cancer patients. |
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